Oil firms are said to have known for decades of the link between burning fossil fuels and climate breakdown. Author Bill McKibben describes how industry lobbying created a 30-year barrier to tackling the crisis. Plus: John Stewart on his campaign to stop the third runway at Heathrow
Before 1988, climate change was a subject confined to the realm of academic journals. That all changed when the scientist James Hansen told Congress that global heating was caused by the buildup of greenhouse gases in the atmosphere as a result of the burning of fossil fuels.
That moment caught the imagination of the journalist Bill McKibben,who has written and campaigned on climate breakdown ever since. And it has been reported that fossil fuel companies, such as ExxonMobil, were making links between the burning of oil and rising sea levels as early as the 1970s. But instead of making their findings public, the industry colluded to cast doubt over the science.
For Marie-Claire Grime, who works in a pharmacy northeast of Paris, questions about vaccines are a daily challenge. They come mainly from parents who say they're worried about "a lot of chemicals" being put into their children, she says. She does her best to allay such fears.
Eventim Apollo, London In Real or Magic? the bicep-piercing endurance artist demonstrates supernatural command of his body
‘The last time I performed in London, I was shut in a box for 44 days.” And pelted with eggs, as David Blaine fails to add. That 2003 stunt backfired, but the stupefaction quotient is high in his touring show Real or Magic? which showcases Blaine’s magic as well as the lengths to which he can push his body. So too is the squirm quotient – I spent a fair chunk of the show looking at anything but the stage.
Squeamish viewers (that’s me!) will wonder how anyone could be entertained by the spectacle of a man piercing his biceps with a metal spike. Or, for that matter, vomiting up pints of water on demand to extinguish a fire. But even if the horror is sometimes a painful watch, the point it’s making – Blaine’s supernatural command of his body – is abundantly made.
Like so many baby boomers I know, I grew up in a home with an absent father. He was brilliant and handsome and had served in the U.S. Air Force. My father had seen too much, lost too much. After World War II, he wanted to forget the horrors that made him grow up so fast. He wanted to forget anything...
Midway through last night’s sixth and deciding game of the NBA Finals against the Golden State Warriors, the Toronto Raptors’ star forward Kawhi Leonard sized things up from the top of the three-point arc. Leonard—6 feet 7 inches tall and 230 pounds, with wide hands and a stony expression—took two hard dribbles to the rim, jump-stopped, and rose for a layup, but the Warriors center Kevon Looney arrived to deliver a hard foul. Leonard muscled through the contact and made the shot anyway, extending the Raptors’ three-point lead and embodying, for a moment, a team-wide theme: of hard work done simply, of advantages unflashily accrued.
By the end of the night, the Raptors had won, 114–110, to take the series four games to two, claiming the first championship in the franchise’s 24-year history and the first NBA title for any team outside the United States. Leonard was awarded Finals MVP, having averaged 28 points and almost 10 rebounds to go along with two steals and one block. Watching him tally these statistics was like watching a well-drilled student work lines of algebra.
As the distinguishing traits of champions go, readiness is not a particularly scintillating one. This is doubly true in the context of recent NBA history, which has taken on the feel of a space race. The Stephen Curry/Kevin Durant/Klay Thompson Warriors have spent the past few years inverting the court, making the far reaches beyond the three-point line the crucial territory, and their competitors have mostly tried to match their boldness, if not their specific strategy. LeBron James assembled a superstar conglomerate in Cleveland and has attempted the same in Los Angeles; the Houston Rockets have run basketball through algorithms. Contemporary thinking says the way to win a title is by reimagining the game.
There is something simultaneously retro and radical, then, about this Toronto team. Since the arrival in 2013 of the team president Masai Ujiri, the Raptors have improved steadily but incrementally. They’ve built around Kyle Lowry, a point guard more suited to hard-nosed defense than three-point heroics. They drafted Pascal Siakam, a springy, rail-thin forward who didn’t start playing basketball until age 15 and who has suddenly, three years into his pro career, become the team’s second-leading scorer. Last off-season, Ujiri traded DeMar DeRozan, an adept mid-range shooter and beloved local figure, to the San Antonio Spurs for Leonard, one of the league’s premier offensive and defensive forces (the move carried risk, as Leonard had feuded with the Spurs’ management and had only one year left on his contract). In February, Ujiri swung a deal for Marc Gasol, a center as comfortable launching jumpers and slinging crosscourt passes as patrolling the paint. No Toronto player was drafted higher than 15th, an unheard-of condition for an NBA finalist.
The resulting array of talent came to reflect something of its designer. If this Finals may be remembered for the limping end of the Warriors’ dynasty—the injuries to Durant (a strained calf and then a torn Achilles tendon) and Thompson (hamstring, then ACL), the overburdened Curry unable to compensate—it also demonstrated Toronto’s aptitude for seizing opportunity in whichever form it presented itself. “They played unselfishly and they played defense,” the head coach Nick Nurse, himself a first-year hire, said from the trophy-presentation podium postgame. “That’s a pretty good combination.”
The Raptors hounded the Warriors’ remaining healthy stars, forcing the ball into the hands of shot-averse players and, on the other end of the court, leveraging straightforward pick-and-rolls and post-ups into open looks. In Game 1, Siakam made 14 of 17 shots for 32 points; in Game 4, Leonard bullied his way to 36; last night, Lowry scored the team’s first 11 points. The backup guard Fred VanVleet, an undrafted player out of Wichita State University, emerged as a folk hero, shadowing Curry on defense and knocking in timely three-pointers whenever they seemed most needed.
One effect of having all these fresh faces—and returning ones; Leonard won the Finals MVP award once before, with the Spurs in 2014—on the NBA’s championship stage was the shaking-up of what had become a tedious LeBron James–versus-Warriors early-summer tradition. The series took on uncommon character. Game 5 saw Golden State pull off a miraculous last-second comeback following Durant’s Achilles injury; Game 6 featured archetypes unavailable to the past few NBA Finals, challengers on the precipice against depleted champions mounting a prideful stand. New figures meant new peripheral reveals, too. Fans delighted at the discovery that Leonard’s trash talk, such as it is, mirrors his pared-to-essentials style of play. College teammates, chased down for between-game fodder, reported that his go-to phrases were clipped and direct: “No” on defense, “Buckets” on offense, the comparatively effusive “Board man gets paid” after a rebound.
More broadly, the Finals signaled the start of a league-wide shift, an end to Golden State’s dominance, if not its relevance. The Warriors will be without the injured Durant and Thompson for at least the better part of next season, and possibly forever—both players are free to leave the team in the summer if they choose. The roster that remains figures to be good but no longer prohibitively favored. The strategic stakes of the league, set for the past half decade by the Warriors, are now a little less urgent. Competing for a title no longer means developing a credible plan to unseat one of the most skilled and pedigreed teams in the sport’s history. That last night’s was the final NBA game played in Oakland’s Oracle Arena—the Warriors will be moving across the bay to a new building in San Francisco next season—has an end-of-an-era resonance.
Toronto might also look different at the start of next season. Leonard, who during the process of leaving San Antonio expressed a preference for teams in his native California, declined to say during the championship celebration whether he intended to resign, and the snakebit Washington Wizards, even as confetti still floated in the air, were reported to be pursuing Ujiri. The Raptors seem unlikely to coalesce into a dynasty; it took an anomaly of physics for them to make it out of the second round. They were built to give themselves a chance, and they’ve proved that doing so is worth it, that titles don’t land with only the sport’s well-stocked futurists. After the locker-room celebration, with goggles on his forehead and champagne soaking his T-shirt, Leonard spoke to the virtues of simplicity. “I just came in with the right mind-set,” he said. “Let’s go out and win ball games.”
Plus: captains born close to the scene of trophy-lifting success, more Davids v Goliaths and the lowest-ranked international Premier League players. Mail us or tweet @TheKnowledge_GU
“After Mesut Özil’s government-endorsed nuptials, have any other players had an equally unlikely or high-level wedding guest?” asks Tony Crawford.
We should point out that Turkey’s president clearly loves a footballer’s wedding. Perhaps it’s the tasty canapés on offer or, more likely, the effect such appearances can have on his popularity. Just over a year before he was best man for Mesut Özil, Recep Tayyip Erdoğan played the same role on Arda Turan’s big day. Erdoğan was also present at Hakan Şükür’s wedding in 1995. But on this occasion, as the mayor of Istanbul, he actually conducted the ceremony. Curiously, the best man was Fethullah Gülen, the leader of the Gülen movement, now a vocal critic and enemy of Erdoğan who is exiled in the United States.
I was standing two feet away when my 74-year-old father slugged an emergency-room doctor who was trying to get a blood-pressure cuff around his arm. I wasn’t totally surprised: An accomplished scientist who was sharp as a tack right to the end, my father had nothing but disdain for the entire U.S. health-care system, which he believed piled on tests and treatments intended to benefit its bottom line rather than his health. He typically limited himself to berating or rolling his eyes at the unlucky clinicians tasked with ministering to him, but more than once I could tell he was itching to escalate.
My father was what the medical literature traditionally labeled a “hateful patient,” a term since softened to “difficult patient.” Such patients are a small minority, but they consume a grossly disproportionate share of clinician attention. Nevertheless, most doctors and nurses learn to put up with them. The doctor my dad struck later apologized to me for not having shown more sensitivity in his cuff placement.
When he wasn’t in the hospital, my dad blew off checkups and ignored signs of sickness, only to reenter the health-care system via the emergency department. Once home again, he enthusiastically undermined whatever his doctors had tried to do for him, practically using the list of prohibited foods as a menu. He chain-smoked cigars (for good measure, he inhaled rather than puffed). He took his pills if and when he felt like it. By his late 60s, he’d been rewarded with an impressive rack of life-threatening ailments, including failing kidneys, emphysema, severe arrhythmia, and a series of chronic infections. Various high-tech feats by some of Boston’s best hospitals nevertheless kept him alive to the age of 76.
It was in his self-neglect, rather than his hostility, that my father found common cause with the tens of millions of American patients who collectively hobble our health-care system.
But lost in these discussions is, well, us. We ought to consider the possibility that if we exported Americans to those other countries, their systems might end up with our costs and outcomes. That although Americans (rightly, in my opinion) love the idea of Medicare for All, they would rebel at its reality. In other words, we need to ask: Could the problem with the American health-care system lie not only with the American system but with American patients?
One hint that patient behavior matters a lot is the tremendous variation in health outcomes among American states and even counties, despite the fact that they are all part of the same health-care system. A 2017 study published in JAMA Internal Medicine reported that 74 percent of the variation in life expectancy across counties is explained by health-related lifestyle factors such as inactivity and smoking, and by conditions associated with them, such as obesity and diabetes—which is to say, by patients themselves. If this is true across counties, it should be true across countries too. And indeed, many experts estimate that what providers do accounts for only 10 to 25 percent of life-expectancy improvements in a given country. What patients do seems to matter much more.
Somava Saha, a Boston-area physician who for more than 15 years practiced primary-care medicine and is now a vice president at the nonprofit Institute for Healthcare Improvement, told me that several unhealthy behaviors common among Americans (for example, a sedentary lifestyle) are partly rooted in cultural norms. Having worked on health-care projects around the world, she has concluded that a key motivator for healthy behavior is feeling integrated in a community where that behavior is commonplace. And sure enough, healthy community norms are particularly evident in certain places with strong outcome-to-cost ratios, like Sweden. Americans, with our relatively weak sense of community, are harder to influence. “We tend to see health as something that policy making or health-care systems ought to do for us,” she explained. To address the problem, Saha fostered health-boosting relationships within patient communities. She notes that patients in groups like these have been shown to have significantly better outcomes for an array of conditions, including diabetes and depression, than similar patients not in groups.
The absence of healthy community norms goes a long way toward explaining poor health outcomes, but it doesn’t fully account for the extent of American spending. To understand that, we must consider Americans’ fairly unusual belief that, when it comes to medical care, money is no object. A recent survey of 10,000 patients found that only 31 percent consider cost very important when making a health-care decision—versus 85 percent who feel this way about a doctor’s “compassion.” That’s one big reason the push for “value-based care,” which rewards providers who keep costs down while achieving good outcomes, is not going well: Attempts to cut back on expensive treatments are met with patient indignation.
For example, one cost-reduction measure used around the world is to exclude an expensive treatment from health coverage if it hasn’t been solidly proved effective, or is only slightly more effective than cheaper alternatives. But when American insurance companies try this approach, they invariably run into a buzz saw of public outrage. “Any patient here would object to not getting the best possible treatment, even if the benefit is measured not in extra years of life but in months,” says Gilberto Lopes, the associate director for global oncology at the University of Miami’s cancer center. Lopes has also practiced in Singapore, where his very first patient shocked him by refusing the moderately expensive but effective treatment he prescribed for her cancer—a choice that turns out to be common among patients in Singapore, who like to pass the money in their government-mandated health-care savings accounts on to their children.
Most experts agree that American patients are frequently overtreated, especially with regard to expensive tests that aren’t strictly needed. The standard explanation for this is that doctors and hospitals promote these tests to keep their income high. This notion likely contains some truth. But another big factor is patient preference. A study out of Johns Hopkins’s medical school found doctors’ two most common explanations for overtreatment to be patient demand and fear of malpractice suits—another particularly American concern.
In countless situations, such as blood tests that are mildly out of the normal range, the standard of care is “watchful waiting.” But compared with patients elsewhere, American patients are more likely to push their doctors to treat rather than watch and wait. A study published in the Journal of the American Board of Family Medicine suggested that American men with low-risk prostate cancer—the sort that usually doesn’t cause much trouble if left alone—tend to push for treatments that may have serious side effects while failing to improve outcomes. In most other countries, leaving such cancers alone is not the exception but the rule.
American patients similarly don’t like to be told that unexplained symptoms aren’t ominous enough to merit tests. Robert Joseph, a longtime ob‑gyn at three Boston-area hospital systems who last year became a medical director at a firm that runs clinical trials, says some of his patients used to come in demanding laparoscopic surgery to investigate abdominal pain that would almost certainly have gone away on its own. “I told them about the risks of the surgery, but I couldn’t talk them out of it, and if I refused, my liability was huge,” he says. Hospitals might question non-indicated and expensive surgeries, he adds, but saying the patient insisted is sometimes enough to close the case. Joseph, like many American doctors, also worried about getting a bad review from a patient who didn’t want to hear “no.” Such frustrations were a big reason he stopped practicing, he says.
In most of the world, what the doctor says still goes. “Doctors are more deified in other countries; patients follow orders,” says Josef Woodman, the CEO of Patients Beyond Borders, a consulting firm that researches international health care. He contrasts this with the attitude of his grown children in the U.S.: “They don’t trust doctors as far as they can throw them.” (For what it’s worth, patients in China may be even worse than American patients in this regard. According to one report, they spend an average of eight hours a week finding and sharing information online about their medical conditions and health-care experiences. Various observers have told me that Chinese patients wield that information like a club, bullying doctors into providing as many prescriptions as possible.)
American patients’ flagrant disregard for routine care is another problem. Take the failure to stick to prescribed drugs, one more bad behavior in which American patients lead the world. The estimated per capita cost of drug noncompliance is up to three times as high in the U.S. as in the European Union. And when Americans go to the doctor, they are more likely than people in other countries to head to expensive specialists. A British Medical Journal study found that U.S. patients end up with specialty referrals at more than twice the rate of U.K. patients. They also end up in the ER more often, at enormous cost. According to another study, this one of chronic migraine sufferers, 42 percent of U.S. respondents had visited an emergency department for their headaches, versus 14 percent of U.K. respondents.
Finally, the U.S. stands out as a place where death, even for the very aged, tends to be fought tooth and nail, and not cheaply. “In the U.K., Canada, and many other countries, death is seen as inevitable,” Somava Saha said. “In the U.S., death is seen as optional. When [people] become sick near the end of their lives, they have faith in what a heroic health-care system will accomplish for them.”
It makes sense that a wealthy nation with unhealthy lifestyles, little interest in preventive medicine, and expectations of limitless, top-notch specialist care would empower its health-care system to accommodate these preferences. It also makes sense that a health-care system that has thrived by throwing over-the-top care at patients has little incentive to push those same patients to embrace care that’s less flashy but may do more good. Medicare for All could provide that incentive by refusing to pay for unnecessarily expensive care, as Medicare does now—but can it prepare patients to start hearing “no” from their physicians?
Marveling at what other systems around the world do differently, without considering who they’re doing it for, is madness. The American health-care system has problems, yes, but those problems don’t merely harm Americans—they are caused by Americans.
Like Spinal Tap, Elizabeth Gilbert goes to 11. Whether it’s the depths of her despair in Eat, Pray, Love, the intensity of her research in her fiction, or the openness with which she shares her life—romantic and otherwise—with her rabid fans, she lives in bold.
Gilbert has something of a two-track career, toggling between carefully crafted fiction and confessional creative essays. The latter, of course, made her a guru for thousands of women who longed for a similar arc of self-discovery and a thrilling life. Now, after the death of her partner Rayya Elias, Gilbert has written a new novel, City of Girls, set in 1940s New York. The work follows a privileged woman’s adventures, headstrong mistakes, and growing self-knowledge. It’s sprawling and colorful, with characters firing off dialogue that would fit in a Howard Hawks movie. I spoke with her about her book, her craft, and what it means to be Elizabeth Gilbert. This interview has been edited and condensed for clarity.
Lizzie O’Leary: This new book inhabits a very complete and discrete world: a sort of crumbling, pre–World War II theater scene with a naive, self-absorbed young woman in it. What was the spark for creating this?
Elizabeth Gilbert: A couple of things. I always feel like there are multiple sparks, and then they conjoin. And then you have a match, and then hopefully it becomes a torch. But I can tell you some of them. One is that I came upon an out-of-print book of essays by Alexander Woollcott, who was, of course, one of the Algonquin Round Table figures, and a critic and columnist for The New Yorker. He was really famous in his day and not at all now.
But it was a collection that included a bunch of profiles that he’d written through the 1930s and ’40s of stage actresses who were coming to New York to work on various productions. There’s something impossibly glamorous about the world that he was describing: going to the Sherry-Netherland in the afternoon and sitting down with the great thespian Katharine Cornell and talking about her upcoming role as Lady Macbeth. I just thought, I want to be in that world.
In a larger sense, I’ve wanted for years to write a novel about promiscuous girls whose lives are not ruined by the often ill-advised choices that they make. And I feel like that’s a difficult book to find in the Western canon, because girls are always so terribly punished for their recklessness. I wanted to write a book about girls—not who get away with it, [not] who have consequence-free sex—but who managed to survive their consequences. A book about female sexual desire and how muscular and messy it can be.
O’Leary: I don’t think I realized that the 1940s involved so much casual sex. Tell me about that part of the research.
Gilbert: Well, I was lucky enough to get an incredible first-person source on that. I had that sense, too, as I was writing. I was thinking, How could there have been such a thing as this?
We have such a naïveté in our imaginations about the reality of sex. There have always been people who have had a lot of sex. There has always been that girl who has come to New York City to test out her powers and the limits of her beauty and her allure. She just arrived in New York City yesterday, she came here in the ’20s, she was here in 1890. The theater world and the entertainment world are a magnet for that kind of girl.
From a historical perspective, you can often tell what people were doing by rules about what they weren’t allowed to do. And also by reading public health records about the spread of venereal disease and how people were getting abortions back then. But my greatest resource was a woman in her 90s named Norma. She had been a showgirl and a dancer at the Stork Club back in the day. She’d been John Wayne’s girlfriend. She was very open talking to me about the five abortions that she’d had in the course of her life—something she spoke about with absolutely no regret or remorse whatsoever—the dozens of lovers that she had, the various venereal diseases that she had, the time that Milton Berle bought her a car.
The primary focus of her life was unbridled sensual exploration. She never married, never had kids. She still lives in the same apartment that she moved into in 1952. And when I asked her, “Did you ever regret not getting married and not having children?” she just rolled her eyes and said, “Who the hell wants to have sex with the same guy for 60 years?” Except she didn’t say “have sex”; she used a much more vulgar term.
O’Leary: A lot of the action is set at the Lily Playhouse, and there is a tension between catering to the working-class neighborhood audience and creating this great big show. It made me wonder how much you think about your very fervent audience and what they want from you.
Gilbert: I think you’re referring to Aunt Peg in the book, my protagonist’s aunt, who runs a really shabby, run-down, almost burlesque theater in Midtown. [It’s] just far enough away from the bright lights of Broadway to not be glamorous, and just close enough to Tenth Avenue to be serving the working-class people of Hell’s Kitchen. She’d also done the same thing during [World War I] for soldiers. She’d come out of the war with a feeling that people are very stressed and in a lot of pain and they need diversion and I’m here to provide it.
So I feel like this book is my version of this at a time that’s not dissimilar to how people were feeling in 1940. There’s a tremendous cloud of dread hanging over the entire dumpster fire of the world right now. I don’t know anybody who’s not stressed and anxious and depressed. What I wanted to give at this moment is a book that would go down like a tray of champagne cocktails and give you a little bit of diversion.
When I wrote The Signature of All Things, for instance, I really did want to write a big, serious, epic, intellectual novel. I knew that I would lose a lot of my readers by doing that, and I was okay with that. I feel like my readers and I don’t owe anything to one another.
O’Leary: Really? They buy your books.
Gilbert: But they’re not required to. And the reason I know that is because they often don’t. They bought millions of copies of Eat, Pray, Love, but they bought dozens of copies of Committed, the book that came after it, because they didn’t want that one. I couldn’t make them if I tried. Likewise, I feel great love and intimacy for them and the interactions that we have, but I don’t feel like I owe them anything either. I should create the work that I want to create and they’re welcome to come along with it if they want to.
O’Leary: I want to ask you about the Brave Magic retreat that you and Cheryl Strayed have done. There was a piece by a writer named Laura Cathcart Robbins in HuffPost about being the only black woman there. Have you read that?
Gilbert: I have read it, yeah. And I was really glad that she wrote it, because it was thoughtful and important. It was an awakening for me as well.
O’Leary: How so?
Gilbert: It was … God. There’s a limit to how much I want to talk about this in a way, and it’s only because I don’t think we need white people talking about white privilege that much. But I will say that it’s changed the way that I’m operating. It was a tricky situation, because it was an open-registration event. We set aside a number of scholarship tickets for people who could apply based on need. It was in Northern California, which is very white, at the Redwoods, which is very white. Our readers are very white.
There’s also something problematic about me saying black women should love my work. But I was distressed by the same exact thing that the woman who was there was distressed by, and I was really grateful that she wrote about it. I’ve been working with my speaking agent and the people who I create these events with to try to figure out how to remedy that. A lot of it is just about going to different locations. So for instance, how about I don’t do that retreat in Napa Valley? Why don’t I go to Jackson, Mississippi, instead and just bring it to a different audience?
I’ve also, in the last year, been doing that exact same retreat for free at various nonprofit organizations. And there is also something problematic about assuming that the reason that there weren’t black women in the audience is because it cost too much.
I’m trying to create events where I can take my spotlight and put it on somebody who might not have the spotlight that I have, and create more diversity not just in the audience, but on the stage. All of this is stuff that I’m working toward remedying; it’s an imperfect science. But what she said needed to be said.
O’Leary: I’ve noticed that in your work and in your reflections on life you treat things such as Ideas and Grief with capital letters, as their own things that exist and don’t necessarily belong to you. Can you explain that concept?
Gilbert: The simplest way to explain my general worldview is it’s kind of pagan. I think that everything is animate and everything has consciousness and will. I don’t think it is a metaphor. When I speak about [an idea] having will and consciousness, it comes and gets your attention and kind of uses you, almost parasitically, to make itself come into being.
It seems to make it easier to do that work … You’re a little bit off the hook. It’s kind of [like] I can make bigger leaps of faith because I believe that a lot of [life] is a mystery and that it’s not all coming from me.
O’Leary: You used the phrase off the hook. I wonder if there is the potential to abdicate responsibility for one’s own emotions and experiences by using this as an animating philosophy. Does it let you skate through life without thinking about the consequences and maybe how they affect other people?
Gilbert: I don’t think life itself will let you do that. I think when you’re out of integrity, you’ll find out very quickly, because exactly that will happen: You’ll get hurt or other people will get hurt and the consequences will rain down upon you and you’ll know it. So there’s a sort of a self-correcting mechanism in there. Also, I think that I have a tremendous amount of reverence for creativity itself, and for the privilege that I have to engage with it, and so the responsibility that I feel is to show up at the very highest possible level that I can. That’s how I remain responsible.
O’Leary: The book also wrestles with the idea of being a person of honor and not turning away from your mistakes. I went back and read this essay you wrote about being a seduction addict. Do you still think of yourself that way?
Gilbert: No. I don’t do what I used to do. I don’t think I would have written that article and revealed that about myself if I still behaved the way that I used to behave.
O’Leary: You fall in love a lot.
Gilbert: Yeah, but there’s a difference between that and seduction … I do fall in love a lot, thank goodness. I put a lot of myself out there in the world. But I behave with honesty, and I think all addiction is based on dissembling and lying, and I can’t do that anymore. Not for very long, anyway, without finding myself in a lot of pain. So I think that’s the major difference.
O’Leary: How do you decide what to share and what to keep private? You expose a lot of what you think and what you’re going through.
Gilbert: I don’t have a process other than my own intuition. I don’t have any rules about it, actually. I wouldn’t know how to set them. I don’t have a social-media manager. I’ve never had a meeting with an expert about how to do this. I just share when I’m ready to share, and I couldn’t even begin to tell you what the calculus is for that other than just deciding that it’s time.
O’Leary: I was looking back through Eat, Pray, Love and I wonder if, for you, it feels like a book of a person in her 30s, where your 30s are consumed with who you are and making it true, and your 40s are like, “Oh, my back hurts and I don’t really care what anyone thinks of me.”
Gilbert: I hadn’t read it in 10 years, but the 10-year anniversary came up recently and my publisher asked me to write a foreword to it. I thought I should probably read it before I write a foreword.
I don’t know if it’s a book for women in their 30s, but it’s certainly a book written by a woman in her 30s. I was struck by how much shame there was in that book, and how apologetic I was as a narrator, about myself, and how embarrassed I was by the fact that I wanted to go on a spiritual journey. I kind of roll myself under the bus a lot in that book.
There is a paragraph that really struck me and actually made me very sad, which is when I was in Italy. I’m having this great meal and I’m actually feeling good, and I’m writing about how, for the first time in three years, I actually feel good. And then I said something that was like, “I know that eventually I’m going to have to settle down and become a responsible, productive, contributing adult. I promise that I will do that soon but just a little while longer let me just do this now.”
And I think that insecurity of a 34-year-old woman who’s saying, “Conventional life; I tried it … I’m going to go do this thing, but I promise it’s just for a year and then I’ll settle down again and I’ll be normal again” didn’t work for me. That’s an insecurity I don’t have anymore. That’s a promise I would never make to anybody again.
Once upon a time, the tech giant let shows linger on well past their best. Now series like Chambers are getting axed after a season. What is behind this lurch into ruthlessness?
By anyone’s standards, Chambers died young. Just 56 short days after debuting on Netflix, it has now been consigned to the bin. “Chambers will not return for a second season,” Nexflix said in a statement on Tuesday. “We’re grateful to creator and showrunner Leah Rachel for bringing this story to us”.
Why was Chambers cancelled so abruptly? It could be down to any number of reasons, although they can probably all be boiled down to a) it was bad and b) nobody watched it. The supernatural thriller, about the recipient of a heart in a transplant who starts experiencing troubling side-effects, was unpleasant, listlessly acted (even though it featured Uma Thurman) and had a title so pointlessly nebulous that it literally could have been about anything, from bedrooms to courtrooms to toilets. All in all, Chambers’s demise was inevitable.
A rainy spring and overflowing Great Lakes are adding to the environmental strain on tiny piping plovers. If waters get too high, teams of professionals and volunteers work as nest security guards and emergency rescuers.
I was at home on a recent Sunday when one of my twin 6-year-old sons did something absolutely adorable, but you’ll have to take my word for it. I’m not showing you the picture. He had spent the whole morning making a complete superhero costume out of paper, and when it was time for him to try it on, I pointed my phone at him, as so many 21st-century parents do. He immediately—and definitively—told me he was not okay with that. “Don’t put that online!”
He didn’t entirely object to digital sharing: After I pleaded for a bit, he gave me permission to send it to a group text of grandparents and cousins. “It’s okay if it’s only family,” he said. I later asked him to tell me a little more about why he didn’t want his photo online, and he explained, “I’m shy. I might get embarrassed if other people saw it who aren’t our friends. Or it got on the news.”
It’s tempting to dismiss these attitudes as naïveté—after all, my son doesn’t yet know what Facebook is, and what he knows about how the internet works, he says, is largely based on an episode of The Magic School Bus. But he is aware of technology and the influence it can have on his life, even if that’s primarily being upset when the Wi-Fi goes down and he can’t watch Pixar on Apple TV.
A child of the ’80s, I too was subjected to parental technological documentation; there are plenty of photographs of me around my mom’s house. But what I endured is nothing like the unblinking surveillance my own children face. Gigabytes and gigabytes of photos and videos are on hard drives and the cloud, chronicling them from birth and even before. Many parents have begun to consider what it means to amass their child’s digital identity before the kid knows what a digital identity is. And even if some technological concepts come easy—my kids seemed to know how to use a touch screen before they could speak or read—they sometimes struggle with forms of media that felt hardwired into my 20th-century brain. The first time we watched a movie on live TV, in a hotel room while on vacation, my kids got upset when we couldn’t rewind to the beginning and were utterly baffled (and annoyed) by commercial breaks. (We don’t allow them to watch YouTube, where they would have become well acquainted with such interruptions.)
Technological change is often measured in terms of new features, specs, and business models. But what people do with the technologies they have is not just about what’s technically possible; it’s a product of zigzagging cultural and psychological moods. Although my son doesn’t use a smartphone much (yet), he is constructing an attitude about what technology should do (bring stuff to him) and not do (transmit his personal details) that I am noticing more lately. Indeed, later that same day, as my family tried a new restaurant near our house, I snapped a photo of my wife enjoying dinner. “Don’t post that to Instagram!” she told me, protesting that she wasn’t wearing makeup. But she said it was fine to text it to some neighbors who were curious about the new place.
The most obvious lesson from all this may be simple: I need to put down my phone. But I also—optimistically, I admit—choose to see these moments as signs of a cultural transformation afoot. The age of sharing is ending, and just as I scoff at the disco era of my parents’ generation, I am hopeful that one day my kids will, after unearthing one of my cringey-er social-media posts, ask me, “You really just put that out on the internet, Dad? What were you thinking?”
The past 20 or so years have been a wild cultural experiment. Many of the things that we tend to think of as permanent additions to our collective cultural habits—publishing a steady stream of short opinions about news, sports, and celebrities and sharing photos and videos of babies, pets, meals, and everyday life with the world—are only a few years old.
Before 1999, few people aside from the most eager of computer enthusiasts would have thought to maintain a digital identity—and fewer still would have known how to even if they wanted to. So it is by no means a stretch of the imagination that all these things that seem so lodged into our culture will change yet again, and all the ingrained habits of the past few years of exploding social media—the YouTube life-streamers, the Instagram influencers, the raging tweetstormers—will be as outmoded and embarrassing to teens and 20-somethings of the future as Disco Stu, clinging to his chest hair and gold medallions.
And while much worthy discussion is being had about the role of the biggest player in social media, Facebook, and whether it’s polluting our media and democracy, I am reasonably sure that my kids will never sign up for a Facebook account. Now, I am not predicting that Facebook or social media will disappear, anymore than the last days of disco meant the end of nightclubs, dancing, cocaine, or casual sex. But even if I don’t know much about the future, I do know this: Kids are never going to think their parents are cool.
The social network is likely to release details of its cryptocurrency this week: and it won’t be much like Bitcoin
First it had your friends, then it had your pictures, then it had your diary. Now, in the latest effort to entwine its systems still further into the everyday lives of its users, Facebook wants to get into your wallet.
On Tuesday, the social media behemoth is expected to reveal its own cryptocurrency, which has variously been called Libra and GlobalCoin. However, unlike other cryptocurrencies, the new creation will not have been founded in the spirit of libertarianism, outside the backing of established, conventional authorities. Instead, it appears to have the endorsement of more than 12 corporations, from Uber to PayPal, Visa and Mastercard.
“We were so terrified with the water coming into the house and the sound of the storm. In front of my eyes, the walls of our house collapsed.” That’s Geeta Maiti, a resident of Mousuni Island, which is part of the Indian Sundarbans—a 4,000-square-mile archipelago that has been designated a World Heritage site. Sitting on the Bay of Bengal, shared by India and Bangladesh, the region has a rich ecosystem that supports the world’s largest mangrove forest and several hundred animal species, including the endangered Bengal tiger. It is home to approximately 13 million people.
All of this could disappear in just a few decades. The Sundarbans is one of the most vulnerable areas to climate change in the world; 70 percent of the land is just a few feet above sea level. In some parts of the region, the sea is already advancing about 200 yards a year. Mousuni Island, in particular, is experiencing the worst effects of the changing climate. Coastal erosion, floods, salinity ingression, and increasingly violent storms have rendered most of the land barren. In the past decade, the island’s inhabitants have seen their houses and livelihoods destroyed. It is now primarily home to women, children, and elderly people, as more than half of the male population has migrated to urban areas for work. Some families have been forced to leave entirely. What was once a self-sustaining agricultural community is now on the front lines of the climate crisis.
The journalists Lisa Hornak and Erin Stone traveled to Mousuni Island to see what life was like for the island’s remaining inhabitants. Their short documentary, Losing Ground, premiering on The Atlantic today, hears from people who fear they will become the next wave of climate refugees—and some who already have. (In 1996, the Sundarbans island of Lohachara became the first inhabited island in the world to be submerged by the sea, and its inhabitants the world’s first climate refugees.)
“We are born farmers,” says one of the men from Mousuni Island in the film. “We don’t have the capacity to do different work. What else can we do? We are surviving, barely.”
Stone says that many climate refugees from across the Sundarbans have migrated to Dhaka, Bangladesh, and now live in conditions of “intense crowding and poverty.” Some families migrated as far as the Middle East to look for work. Hornak told me that this phenomenon is indicative of a growing trend. “We will likely see a shift in how our societies are structured,” she said.
While the economic and geopolitical struggles facing the residents of Mousuni Island are salient, the film also focuses on the emotional toll that the permanent environmental changes have taken on residents.
“I wanted to pursue a story that centered [on] people’s internal worlds as they experienced the intense external pressures caused by climate change and poverty,” Stone told me. She hoped these stories might help humanize the plight of climate refugees. “Many people can understand the pain of a loved one having to move or travel seasonally for work. Many people can understand the devastation that would be caused if they lost their home or livelihood. Everyone can understand love. Everyone can understand the importance of home—and imagine the trauma of being forcibly displaced from it.”
Hornak pointed out one of the great tragedies of the situation in the Sundarbans: Mangrove forests are some of the most effective known carbon sinks. In other words, mangroves naturally remove CO2 from the atmosphere and store it in their soil, a process known as carbon sequestration. (A 2017 study showed that Sundarbans mangroves removed 98 percent of the carbon emitted by a local power plant in one year from the atmosphere.)
What’s more, the inhabitants of the Sundarbans produce a nominal carbon footprint compared with much of the rest of the world. Stone said this unequal distribution of climate consequences is likely to continue. “It is the people who have almost zero contribution to the greenhouse gases that fuel global heating who are most impacted.”
The surprise success of devastating fact-based dramas Chernobyl and When They See Us has shown that summer audiences aren’t always seeking escapism
Before it had even reached its conclusion, Chernobyl had topped IMDb’s user-voted Best Television Shows of All Time list. It has been critically adored and its success has spurred Sky Studios, who co-produced the drama with HBO, to double its investment in original content, in order to compete with the likes of Netflix. Netflix, meanwhile, has boasting rights of its own: its Ava DuVernay-directed series When They See Us has been its most-watched drama every day since it premiered on 31 May. Both revisit true stories that are awful, outrageous and infuriating, and as such, both make for harrowing viewing experiences. They are not so much escapist TV as fully immersive experiences of tragedy. These are not the kind of series you put on to switch off. They are the feel-bad hits of the summer.
Today Alabama enacted a law that will require, as a condition of parole, that some convicted child sex offenders undergo “chemical castration.”
The new law will mean that those who abused children under the age of 13 will be injected with hormone-blocking drugs before leaving prison. The medication will have to be administered until a judge, not a doctor, deemed it no longer necessary.
A similar bill was proposed last year in Oklahoma but met strong opposition. The former Soviet republic of Moldova also passed a law mandating chemical castration for child sex offenders, in 2012. It was repealed the following year on grounds that it was a “violation of fundamental human rights.”
Unlike castrating a bull, chemical castration does not involve removing a person’s testicles—though the Alabama bill’s sponsor, Representative Steve Hurst, initially advocated the surgical approach. Instead, the procedure uses various drugs to render the testicles irrelevant. In most cases, medication triggers the pituitary gland to reduce testosterone to prepubescent levels. During debate of the bill, Hurst said that if chemical castration, which has a stated goal of decreasing libido to prevent future crimes, “will help one or two children, and decrease that urge to the point that person does not harm that child, it’s worth it.”
If we could put ethical considerations about nonconsensual medical treatment aside, it still wouldn’t be clear whether this approach will have the desired effect on recidivism. Most research in the area puts sexual desire low on the list of reasons people assault children. The best predictor of sexual assault is not libido, research has shown, but “an early and persistent general propensity to act in an antisocial manner during childhood and adolescence.”
The physiological effects of androgen blockers are well established, because the drugs used in chemical castration are also commonly used in people with cancer, especially of the prostate, where testosterone can help tumors grow. In addition to lowering libido and causing sexual dysfunction, the sudden removal of androgenic hormones has been known to impair performance on visual-motor tasks and cause declines in bone density, increased rates of fractures, and depressive symptoms.
It has been well demonstrated that surgical castration, which has been practiced in various places for millennia, makes sex offenders either unwilling or simply unable to commit future offenses. The evidence on chemical castration is much less clear. In the same way that removing the hands of a bread thief could theoretically help prevent future crimes, rendering a person’s genitals less virile makes certain acts less feasible. But unlike other therapeutic approaches, chemical castration (or surgical castration, for that matter) does not address the antisocial instincts that often underlie such crimes.
Some ethicists argue that child offenders are diseased, and it is only humane to treat them—even sometimes without consent. This is predicated on the basic idea that assault is a result of an imbalance of hormones, whereby too much testosterone leads to rape. On the whole, however, sex offenders do not have higher levels of testosterone than the average male. A recent meta-analysis of research found “no evidence to suggest there is anything chemically wrong with sexual offenders.”
Assault is not a typical outlet for those who have strong libidos or think often about sex. The desire to take another person by force has long been known to be primarily about power and dominance. If chemical castration is indeed effective, the meta-analysis notes, “it is not because it is treating an abnormal medical condition, but rather because it is inhibiting sexual functioning in the same way it would for most humans.”
In psychiatry, there are some accepted uses for androgen-blocking medications. As the Johns Hopkins psychiatrist Fred Berlin has noted, in these cases drugs are used for “diminishing the intensity of the eroticized urges that energize unacceptable para-philic behaviors”—in other words, when a person is concerned about acting on urges they know to be wrong or illegal, and so seeks preventive help. Other people seek help when an all-consuming libido becomes a problem in daily life.
Research has found small reductions of recidivism among convicted sex offenders when they request chemical castration in conjunction with other therapeutic measures. Small studies have found that recidivism decreased when offenders received antidepressant medications, not anti-testosterone medications.
These findings largely leave the question of whether the technique should be used to the realms of ethics and legality, not medicine. Some legal scholars believe mandatory chemical castration violates the Eighth Amendment, which bans cruel and unusual punishment. The University of Florida law professor John Stinneford has called the practice “maiming” and “impermissibly cruel.” (Hurst, the Alabama bill’s sponsor, did not respond to a request for comment.)
Even when chemical castration is voluntary—which other legal scholars argue can never be the case, due to the coercive subtext of lessening prison sentencing for seeking the procedure—treatment of “hypersexuality” has a loaded history in the United States and elsewhere. The medical establishment and government have long erred on the side of narrowly defining normalcy and punishing “deviancy,” as they have with homosexuality, which was removed from psychiatry’s Diagnostic and Statistical Manual of Mental Disorders only in 1973.
This change came after researchers began documenting in mainstream journals the wide variations in human sexuality. The range of what was “normal” began to separate from morality and expand to show that the idea of what constitutes sexuality is vast and complex. Today, the psychiatric establishment still uses a diagnosis of hypersexual disorder, but the concept has shifted from a more rigid imposition of norms to an idea about how a person relates to sex. There is no cutoff for what is too much sexuality. Some people have sex multiple times a day; others rarely have sex. Hypersexual disorder is currently defined only insofar as it causes distress: When you lose your job because you need to keep having sex, or when your relationship falls apart because you lose all interest in sex, you may have reason to seek care.
If there is a role for the medical community in preventing assault, it is to help equip willing patients relate to people in healthy ways—to treat whatever psychological element precludes healthful, pro-social behavior. If such people find themselves in court, they could be offered the same option. This has been the suggestion of some physicians in South Korea, for example, who argue that chemical castration can be an effective tool for offenders who want and consent to the treatment “within the context of simultaneous comprehensive psychotherapeutic treatment.” Denmark has implemented options for “sexological treatment” of some sex offenders that includes therapy and androgen-blocking medications.
In every case, though, the suggestion is that this would be consensual, voluntary care. It would heed the words of Berlin, the Johns Hopkins psychiatrist, who writes that chemical castration cannot “effectively assist” a person “who lacks a sense of conscience and moral responsibility by somehow instilling appropriate values.”
To have the state impose mandatory standards of behavior toward other people is one thing; to forcibly regulate someone’s internal sex drive is another.